EDUARDO DANIEL MORENO MANDUJANO PA
NPI 1144813890
Physician Assistant in Tallahassee, FL

Q: What is Eduardo Moreno Mandujano's NPI number?

The NPI number for Eduardo Moreno Mandujano is 1144813890. It was assigned to this individual provider in the NPPES registry on February 13, 2021.

Q: What is Eduardo Moreno Mandujano's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Active since February 13, 2021PECOS EnrolledAccepts Medicare Assignment

2907 KERRY FOREST PKWY, TALLAHASSEE, FL 32309(850) 900-1900(850) 900-2900 Get Directions Write a Review

NPPES record last updated: June 30, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Eduardo Daniel Moreno Mandujano Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EDUARDO DANIEL MORENO MANDUJANO PA (NPI 1144813890) is an individual physician assistant in Tallahassee, Florida, licensed in Florida (PA9115758) and active in the NPI registry since February 2021. He is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1144813890

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameEDUARDO DANIEL MORENO MANDUJANOCredential: PA

Location Address2907 KERRY FOREST PKWYTallahassee, FL 32309-6825

Mailing Address2907 Kerry Forest PkwyTallahassee, FL 32309-6825 · (850) 900-1900 · Fax (850) 900-2900

Phone(850) 900-1900

Fax(850) 900-2900

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateFebruary 13, 2021

Last NPPES UpdateJune 30, 2026

NPPES CertifiedJune 30, 2026

✔ NPI 1144813890 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in FL · PA9115758

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

2907 KERRY FOREST PKWY, Tallahassee, FL 32309

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Health Maintenance Organization of Florida.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Eduardo Daniel Moreno Mandujano Pa is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4587068192

PECOS Enrollment IDI20230213001672

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32309 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$87.62 typical visit price

range $56.00 – $171.84

Typical copayment $21.90 (range $14.00 – $42.96)

Most-billed visit code 99203

Established Patient

$70.04 typical visit price

range $17.57 – $139.16

Typical copayment $17.51 (range $4.39 – $34.79)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RICHARD THOMAS DONOVAN P.A.-C

Physician Assistant (Medical)